Duodenum-preserving total pancreatic head resection for cystic neoplasm—a limited but cancer-preventive procedure

Abstract

A duodenum-preserving total pancreatic head resection is a limited surgical procedure for patients who suffer a local monocentric, cystic neoplastic lesion in the pancreatic head. Absence of an advanced pancreatic cancer and completeness of extirpation of the benign tumor determine the long-term outcome. In regards to the location of the lesion in the pancreatic head, several modifications have been applied with low hospital morbidity and mortality below 1%.

Robot‐assisted duodenum‐preserving pancreatic head resection with pancreaticogastrostomy for benign or premalignant pancreatic head lesions: a single‐centre experience

“…From an oncological point of view, DPPHR is a suitable alternative to PD for treating benign, premalignant or even carcinoma in situ pancreatic head tumours. As surgical margins and invasive components are strongly correlated with postoperative recurrence, intraoperative frozen sections should be routinely performed to exclude the involvement of surgical margins and invasive carcinoma . A frozen section of the margins demonstrating borderline atypia or PanIN 3 abnormalities in IPMN or PanIN 3 abnormalities in MCN necessitates a re‐resection.…”

Duodenum‐preserving versus pylorus‐preserving pancreatic head resection for benign and premalignant lesions

“…Various alternative surgical options have been proposed during the past two decades for the management of such benign or borderline lesions of the pancreatic head . Among them, DPPHR was the more frequently used procedure, although only 132 patients are reported in the English‐language literature [2, 12, 13, ].…”

Comparison of Efficacy of Enucleation and Pancreaticoduodenectomy for Small (<3 cm) Branch Duct Type Intraductal Papillary Mucinous Neoplasm Located at the Head of Pancreas and the Uncinate Process

“…However, duodenum preserving pancreatic head resection is technically more demanding than PD. Numerous studies have examined the feasibility of surgical resection of a small branch duct IPMN, however, most of them have focused only on organ preserving pancreatic resection 5-7. We, therefore, compared the efficacy of enucleation with that of PD in patients with small (2 cm<size<3 cm) branch duct IPMN located at the head of pancreas and uncinate process.…”